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Midterm results after modified Epping procedure for trapeziometacarpal osteoarthritis
Silvan M Klein1, Gisela Breindl, Michael Koller
1Center of Plastic-, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93042, Regensburg, Germany. silvan.klein@klinik.uni-regensburg.de
Archives of Orthopaedic and Trauma Surgery
|May 22, 2013
Summary
This study shows a modified Epping procedure improves trapeziometacarpal joint (TMJ) stability and work performance in patients with TMJ osteoarthritis. Most patients experienced better manual function and quality of life after surgery.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Osteoarthritis research
Background:
- Trapeziometacarpal joint (TMJ) osteoarthritis presents challenges with work performance due to joint instability.
- Existing surgical treatments for TMJ osteoarthritis have variable outcomes regarding functional recovery.
Purpose of the Study:
- To evaluate the efficacy of a modified Epping procedure for enhancing TMJ stability in patients with TMJ arthritis.
- To assess the impact of this modified procedure on patient work performance, pain, and overall quality of life.
Main Methods:
- A cross-sectional study involving 71 patients who underwent a modified Epping procedure with a flexor carpi radialis tendon sling.
- Follow-up on 59 patients after a mean of 38 months, assessing pain (VAS), functional outcomes (pinch/grip strength, DASH score), and quality of life.
Main Results:
- 85% of patients achieved full or partial restoration of manual work performance.
- 81% showed improvement or maintenance of strength and activities of daily living (ADL).
- Mean DASH score was 26.6, with low pain levels during rest and mild activity.
Conclusions:
- The modified Epping procedure effectively improves TMJ stability, leading to satisfactory work performance and adequate motion for ADL.
- Patients with co-existing hand pathologies may experience less favorable outcomes.
- This surgical technique offers a viable option for managing TMJ osteoarthritis, particularly for improving functional capacity.